Impact of polypharmacy on all-cause mortality and hospitalization in incident hemodialysis patients: a cohort study.
Aged
Aged, 80 and over
Female
Follow-Up Studies
Hospitalization
/ statistics & numerical data
Humans
Japan
/ epidemiology
Male
Middle Aged
Mortality
Patient Admission
/ statistics & numerical data
Patient Discharge
/ statistics & numerical data
Polypharmacy
/ statistics & numerical data
Proportional Hazards Models
Prospective Studies
Renal Dialysis
All-cause mortality
Hemodialysis
Hospitalization
Polypharmacy
Journal
Clinical and experimental nephrology
ISSN: 1437-7799
Titre abrégé: Clin Exp Nephrol
Pays: Japan
ID NLM: 9709923
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
21
02
2021
accepted:
08
06
2021
pubmed:
16
6
2021
medline:
27
1
2022
entrez:
15
6
2021
Statut:
ppublish
Résumé
Polypharmacy (PP) is common in end-stage chronic renal disease patients largely due to the presence of multiple comorbid conditions. Although PP is potentially harmful, its relationship with mortality and morbidity in hemodialysis patients currently remains unclear. Study design: cohort study. participants: one hundred and fifty-two initial hemodialysis patients (male, 88 patients; mean age, 70.3 years) were enrolled between February 2015 and March 2018 at Nobeoka Prefectural Hospital and Chiyoda Hospital. patients were divided into 2 groups according to PP (6 or more drug prescriptions or less) during admission and discharge for the initiation of hemodialysis. all-cause mortality and hospitalization during the mean 2.8-year follow-up. hazard ratios (HRs) were estimated using Cox's model for the relationships between PP and clinical outcomes and adjusted for potential confounders. The group with 5 or less drug prescriptions was set as a reference. The number of prescribed drugs per patient averaged 7.4 at admission and 7.0 at discharge for initial hemodialysis. One hundred (65.8%) and 94 patients (61.8%) had PP at admission and discharge, respectively. During the follow-up, 20 patients died and 71 were hospitalized. PP at admission did not correlate with outcomes, whereas that at discharge correlated with all-cause hospitalization. PP at discharge may be associated with clinical outcomes. However, it remains unclear whether PP is the direct cause of outcomes or is simply a marker for an increased risk of outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Polypharmacy (PP) is common in end-stage chronic renal disease patients largely due to the presence of multiple comorbid conditions. Although PP is potentially harmful, its relationship with mortality and morbidity in hemodialysis patients currently remains unclear.
METHODS
METHODS
Study design: cohort study.
SETTING
METHODS
participants: one hundred and fifty-two initial hemodialysis patients (male, 88 patients; mean age, 70.3 years) were enrolled between February 2015 and March 2018 at Nobeoka Prefectural Hospital and Chiyoda Hospital.
PREDICTOR
METHODS
patients were divided into 2 groups according to PP (6 or more drug prescriptions or less) during admission and discharge for the initiation of hemodialysis.
OUTCOMES
RESULTS
all-cause mortality and hospitalization during the mean 2.8-year follow-up.
MEASUREMENTS
METHODS
hazard ratios (HRs) were estimated using Cox's model for the relationships between PP and clinical outcomes and adjusted for potential confounders. The group with 5 or less drug prescriptions was set as a reference.
RESULTS
RESULTS
The number of prescribed drugs per patient averaged 7.4 at admission and 7.0 at discharge for initial hemodialysis. One hundred (65.8%) and 94 patients (61.8%) had PP at admission and discharge, respectively. During the follow-up, 20 patients died and 71 were hospitalized. PP at admission did not correlate with outcomes, whereas that at discharge correlated with all-cause hospitalization.
CONCLUSIONS
CONCLUSIONS
PP at discharge may be associated with clinical outcomes. However, it remains unclear whether PP is the direct cause of outcomes or is simply a marker for an increased risk of outcomes.
Identifiants
pubmed: 34129133
doi: 10.1007/s10157-021-02094-9
pii: 10.1007/s10157-021-02094-9
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1215-1223Informations de copyright
© 2021. Japanese Society of Nephrology.
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